One of the most disturbing stories that emerged from the recent events in New Orleans was the plea for infant formula from parents with starving babies. The catastrophe already seemed worsened by largely avoidable situations – lack of water, adequate shelter, emergency services – but why the dependence on infant formula?
It is the poor in the US, as elsewhere, who have the most to gain from breastfeeding and the most to lose from using formula. Where family and community health is compromised by poor nutrition, inadequate housing and limited access to health care, breastfeeding provides a significant leg up for infants.
These children will be less likely to die as infants (‘Post-neonatal infant mortality rates in the United States are reduced by 21 per cent in breastfed infants’ American Association of Pediatrics report), they will have fewer (or less severe) diseases and their cognitive development will be enhanced. Their mothers will have delayed return to fertility and they will be protected against premenopausal breast cancer and osteoporosis. Their family’s limited budget will not be drained further by the cost of infant formula and they will not be at risk at times of disaster, when formula, clean water and sterile equipment are in scarce supply.
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In addition to the health and financial benefits, breastfeeding provides stability and continuity which are undermined by poverty. Sydney Psychologist Robin Grille, in his recent book, Parenting for a Peaceful World, writes:
As emotionally nourishing as it is nutritional, breastfeeding is an essential building block of emotional intelligence, imbuing the child with a reservoir of tranquility, security, connectedness to others and generosity. Breastfeeding affords a vital psychological and immunological sustenance long after it is nutritionally essential. Babies hunger for much more than milk, they hunger for intimacy; to drink-in maternal love.
Yet it is the poor who are more likely to use infant formula. In the US in 2003, the at birth rate of breastfeeding among white mothers was 72 per cent. Amongst black mothers it was 51 per cent. Younger mothers (under 20) are even less likely to breastfeed.
In Australia in 2001, 83 per cent of infants were breastfed at birth and 48 per cent at six months. While this compares well with the US and UK, it is well below Norway where 80 per cent of babies are fully breastfed at six months (click here for more details).
Establishing and maintaining an ongoing breastfeeding relationship is easier said than done. Women do not have role models many giving birth to their first baby have never seen a child being breastfeed and are unlikely to have been breastfed by their mothers. They lack confidence – in the face of difficulties women are advised to use formula in a culture addicted to convenience. They lack information many breastfeeding difficulties that cause women to stop breastfeeding, such as nipple damage or under supply, are due to incorrect positioning and scheduled feeding. Moreover many women returning to the paid workforce are unaware of ways to maintain lactation whilst away from their babies.
It is true that some women are simply unable to breastfeed and need to use infant formula. Their numbers, however, would be a fraction of those currently using formula.
Beyond the health benefits specifically for infants and mothers, the American Association of Pediatrics report also identifies significant economic, family, and environmental benefits. These include the potential for decreased annual health care costs of US$3.6 billion for the United States; decreased costs for public health programs; decreased parental employee absenteeism and associated loss of family income; more time for attention to siblings and other family matters as a result of decreased infant illness; decreased environmental burden for disposal of formula cans and bottles; and decreased energy demands for production and transport of artificial feeding products (click here for more details).
The irony of the tragedy in New Orleans and other parts of the Gulf is that the women holding their hungry dehydrated children could have put them to the breast and soon begun re-lactating. This lack of information and education is even more tragic than the lack of formula.
Australian Breastfeeding Association’s booklet on ‘Relactation and Adoptive Breastfeeding’.
Robin Grille, Parenting for a Peaceful World.
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